[Randomized controlled trial of sequence mass screening program for colorectal cancer]

X Liu, S Zheng, K Chen, X Ma, L Zhou, H Yu, K Yao, K Chen, S Cai, S Zhang
Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi 2000, 21 (6): 430-3

OBJECTIVE: In order to assess the effectiveness of mass screening program for colorectal cancer, a sequence mass screening program based on RPHA-FOBT and individual quantitative risk assessment model (attributive degree value, AD) was used and evaluated on its effectiveness in a randomized controlled trial.

METHODS: The residents of Jiashan county aged 30 years and over were randomized to either screening or control groups in 1989. Participants in screening group were asked to fill in a questionnaire and to submit one paper slide with stool. Participants who tested positive underwent diagnostic evaluations including flexible sigmoidoscopy and colonoscopy.

RESULTS: According to the cancer registry of Jiashan, after initial mass screening in 1989, the 8-year cumulative incidence per 1,000 of colorectal cancer in screening and control groups appeared to be 3.95 (95% CI 3.81 - 4.10) and 4.01 (95% CI 3.86 - 4.16) respectively. There was no significant statistical difference between two groups (P > 0.05). Nevertheless, the 8-year cumulative mortality for colorectal cancer in screening group (2.08 per 1,000; 95% CI 1.96 - 2.18) was reduced 14.7% comparing with the control group (2.44 per 1,000; 95% CI 2.33 - 2.55). In particular, the cumulative mortality of rectal cancer was significantly (31.7%) lower than that in control group. Log-rank test showed that survival rate of rectal cancer in screening group was higher than that in controls (log-rank = 9.01, P = 0.0027).

CONCLUSIONS: The sequential mass-screening program which based on RPHA-FOBT and ADV might reduce the mortality for colorectal cancer in the Chinese population.

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